New ACA Enrollment Data Shows Result of Presidential and Congressional Actions: 1.2M Fewer Americans Covered; Premium Increases; Many More in High-Deductible Plans

03.27.2026 /Statement

WASHINGTON, D.C. - Anthony Wright, Families USA's Executive Director, issued the following statement in response to the release of Affordable Care Act (ACA) marketplace 2026 effectuated enrollment data released by the Centers for Medicare & Medicaid Services. The data shows 23.1 million people enrolled in coverage in 2026, down from 24.3 million in 2025, a decrease of 1.2 million people, or nearly 5 percent - the first decrease of enrollment in five years. The data also shows major premium increases, and a marked increase in Americans moving into high-deductible plans.

"Today's data confirms that deliberate decisions by President Trump and Congress have driven millions more Americans to be uninsured or underinsured. After five straight years of enrollment increases, this year, 1.2 million fewer Americans are insured through the ACA marketplaces. We see the result of these new policies: people paying much more in premiums and getting less.

"Last year, Congress made it harder to get on and stay on coverage for those buying individually or as families in ACA marketplaces. In particular, the President and Congress failed to extend the enhanced premium tax credits that made health coverage more affordable for millions. These actions pushed and priced people out of coverage, or into high-deductible plans.

"The new data shows that after years of moderate increases, the average premium spiked from $619 to $741 a month. The average monthly premium after assistance was $111-113 the last few years and has now jumped up to $178 - an average annual increase of $780, and thousands of dollars for many due to their age or income.

"The result is more uninsured, and a dramatic shift into worse coverage: enrollment in lower-level, higher deductible bronze plans jumped 10% - from 30% in 2025 to 40% in 2026. People now have to choose skimpy, bare bones plans with deductibles often over $10,000 because lawmakers refused to extend the enhanced tax credits.

"And these marketplace enrollment numbers are only the tip of the iceberg - as many as 10 million more are projected to lose Medicaid coverage as a result of H.R. 1's devastating cuts to Medicaid.

"At the same time, policymakers have done nothing to confront the real drivers of rising premiums: unchecked hospital and provider prices due to health care consolidation, rising prescription drug costs, and a worsening risk pool as healthier individuals are driven out of the marketplace after those enhanced tax credits expired.

"The short-term solution was clear - extend the enhanced premium tax credits to keep monthly premiums affordable for 22+ million Americans. Instead, families are now paying hundreds or even thousands more for coverage, if they can afford it at all.

"Congress must act immediately to address our health care affordability crisis, or they'll hear about it at the ballot box in November. This new data should cause a reckoning for the Republican Congressional leadership that continues to block the extension of enhanced premium tax credits that a majority of the Senate and the House have supported, as well as for President Trump, who put in place new barriers to marketplace enrollment."

Families USA will continue to review the 2026 enrollment data, with future analysis forthcoming